title: Should air medical patients be transferred on helipad or trauma bay?
abstract: OBJECTIVE
  Helicopter emergency medical services (HEMS) are widely used in regional trauma care and present unique challenges in the patient handoff process. In particular, the practice of patient handoff on the landing zone versus the trauma bay does not exist in ground emergency medical services. We hypothesized that patients handed off on the landing zone versus the trauma bay would have different patient characteristics and outcomes.
  
  
  METHODS
  A retrospective review identified 305 HEMS trauma patients received at our level 1 trauma center over a 3-year period. Patients were sorted on the basis of the handoff location, (landing zone vs. trauma bay) and assessed for predictors of injury severity including the Revised Trauma Score, the Injury Severity Score, the Trauma and Injury Severity Score, and other outcomes, primarily mortality.
  
  
  RESULTS
  Of the 305 patients, 235 (77%) were handed off in the bay, and 70 (23%) were not. Regarding the characteristics of patients who were handed off in the bay, they were more likely to have hypotension (100% vs. 73%), have a lower O(2) saturation level (97.9 vs. 99.4), and a lower Glasgow Coma Scale at the scene (10.9 vs. 13.9.). When controlling for injury severity, the odds of survival for patients who were handed off in the bay were 11.06 times the odds for patients who were not handed off in the bay.
  
  
  CONCLUSIONS
  In this limited study, we found that HEMS did identify the sickest patients and brought them to the trauma bay. Despite their greater injury severity, the patients handed off in the bay fared better than those handed off on the landing zone.
authors.affiliation: Section on EMS/Disaster Medicine/Homeland Security Division of Emergency Medicine, UT Southwestern, Dallas, Texas, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lehrfeld
authors.forename: Robert
authors.initials: R
authors.lastname: Gemignani
authors.forename: Adam
authors.initials: A
authors.lastname: Shiroff
authors.forename: Sarah
authors.initials: S
authors.lastname: Kuhlmann
authors.forename: Pamela
authors.initials: P
authors.lastname: Ohman-Strickland
authors.forename: Mark A
authors.initials: MA
authors.lastname: Merlin
mesh_terms: D000293:Adolescent; D000328:Adult; D017732:Air Ambulances; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D062209:Patient Handoff; D010360:Patient Transfer / Q000379:methods*; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods; D014193:Trauma Centers; D055815:Young Adult